Dr Margaret Chan
I was struck by the words, recorded in this booklet, of a teenager from Manila. She was explaining what multidrug-resistant tuberculosis has meant for her life. “I want to be a nurse and help others who are sick,” said Charlene Laguinday. “I want to give back what was given to me.”
Charlene has personally experienced the toll of this airborne infectious disease that sickens and kills so many people every year. She recently lost her mother to multidrug-resistant tuberculosis, or MDR-TB. She is now undergoing treatment for the same disease, and her health is improving with every week.
Her experience demonstrates the importance of high commitment to good-quality TB control. MDR-TB, which can spread from one person to another, is a tragedy that should not happen. Properly managed, TB can be cured. Poorly managed, TB can develop into a form that resists multiple drugs, with successful treatment undermined and costs multiplied at least 100 times.
The figures are alarming. MDR-TB is now causing an estimated half a million new cases every year. The stories collected in this booklet give you an idea of the suffering behind the statistics. Even more ominous is the recent rise of extensively drug-resistant TB, or XDR-TB. This form of the disease, which is extremely difficult to diagnose and in some cases impossible to treat, is now being reported from more than 50 countries.
If the right action is not taken right now, the continuing spread of MDR-TB could transform a disease that is curable with affordable medicines into a costly and deadly epidemic. If the right action is not taken right now, the continuing rise of XDR-TB could take the world back to the era that predates the development of antibiotics, with nothing in hand to guarantee treatment success.
This would be a vastly bigger tragedy. Some countries burdened with MDR-TB are showing the way forward with commitment, leadership and good results. However, to tackle this preventable problem on an adequate scale, national TB control programmes will depend on progress on a larger health agenda that aims at universal health coverage, high-quality patient-centred care, laboratory strengthening and infection control in health facilities. That agenda must also include improved mechanisms for drug prequalification and rational use of drugs, as well as the intensive engagement of the private sector, patients and communities.
I urge you to read the personal stories collected in AIRBORNE. These are human tragedies that should never have happened. But these are also stories about the uplifting success possible when the right elements are in place.
I further urge you to accept this call to action. The microbial world has given us a clear either-or situation. Either we tackle the problem now with rational and proven approaches, or we pay later with an epidemic of an airborne disease that renders our modern-day medicines and straightforward treatment regimens obsolete. This would truly be a tragedy, on a huge and costly scale, that should not happen.